NOVEL CORONAVIRUS INFECTION (COVID-19): GUIDING PRINCIPLES FOR OBSTETRIC CARE UNDER PANDEMIC CONDITIONS


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Abstract

The literature review analyzes the latest data on the principles of diagnosis and treatment of the novel coronavirus infection, management of pregnancy, childbirth, and the postpartum period during a pandemic, as well as the benefits and risks of breastfeeding with confirmed COVID-19 infection on the basis of the clinical guidelines of the Russian and international professional associations and the results of several basic studies and clinical trials. In late 2019, the global medical community faced the new infection transmitted through airborne droplets. Being initially identified as one of the acute respiratory viral infections, the novel coronavirus infection was included in the list of diseases that pose a risk to others on January 31, 2020. A little later, on March 11, 2020, the World Health Organization (WHO) stated that the infection reached the level of a pandemic. The high-risk group includes the elderly, patients with severe concomitant diseases and immunodeficiency, as well as pregnant women with altered immune responsiveness. At the same time, the pregnancy status restricts the use of some methods for instrumental diagnosis and anti-coronavirus therapy. An obstetrician-gynecologist is responsible not only for the health of an infected woman, but also for that of her unborn child, therefore the specialist must know all the transmission routes of infection, follow epidemiological precautions, be able to identify early symptoms of the disease, perform thorough clinical assessment and provide timely adequate anti-coronavirus therapy. The management of women during pregnancy, childbirth, and postpartum should be carried out according to the potential risk of this infection. The paper provides useful algorithms for actions during the initial hospital admission of a pregnant woman, her further examination and treatment.

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About the authors

Irina V. IGNATKO

I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia

Email: iradocent@mail.ru
MD, PhD, professor at the Department of Obstetrics, Gynaecology and Perinatology Moscow, Russia

Alexander N. STRIZHAKOV

I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia

Email: kafedra-agp@mail.ru
Academician of the Russian Academy of Sciences, MD, professor, Head of the Department of Obstetrics, Gynecology and Perinatology, Faculty of Medicine Moscow, Russia

Elena V. TIMOKHINA

I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia

Email: kafedra-agp@mail.ru
Professor, Doctor of Medical Sciences, Professor of the Department of Obstetrics, Gynecology and Perinatology, Faculty of Medicine Moscow, Russia

Yulia V. DENISOVA

I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia

Email: yuliya.sheveleva.97@mail.ru
student Moscow, Russia

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